Elderly patients with lung cancer have a significantly increased risk of perioperative cardiopulmonary complications due to physiological decline, high incidence of complications and reduced surgical tolerance, which directly affects postoperative recovery and long-term survival. Although the concepts of minimally invasive surgery and enhanced recovery after surgery have improved clinical outcomes, early recognition and intervention of postoperative complications in elderly patients remains a significant challenge in the field of thoracic surgery. By integrating recent literature and clinical practice, this paper systematically analyzes the pathophysiological mechanism and risk factors of perioperative cardiopulmonary complications in elderly patients with lung cancer, and discusses individualized intervention strategies based on risk stratification and multidisciplinary team, in order to provide theoretical basis and practical guidance for optimizing perioperative management and improving postoperative prognosis in elderly patients.

Objective:To investigate the prevalence status and the clinical characteristics of hepatitis D virus (HDV) among patients chronically infected with hepatitis B virus (HBV) in the Xinjiang region.Methods:A cross-sectional study was conducted. Serum samples from 1 830 patients with chronic HBV infection who visited the Traditional Chinese Medicine Hospital of Xinjiang Uygur Autonomous Region from December 2022 to October 2023 were collected. All sera were tested for anti-HDV IgG and IgM. Sera positive for anti-HDV IgG or IgM were selected for HDV RNA detection. HDV RNA-positive sera were sequenced to determine the HDV genotype. Age, gender, HBV course, and anti-HBV treatment status were used as scoring items based on the propensity score matching (PSM) method. Chronic HBV patients with negative anti-HDV were matched in a ratio of 1∶1. The clinical characteristics of anti-HDV -positive-patients were analyzed. The t-test was used for comparison between groups of normally distributed continuous data. The Wilcoxon signed-rank test was used for comparison between groups of skewness distribution. The χ2 test was used for comparison between groups of enumeration data. Results:The positive detection rates of anti-HDV IgG, anti-HDV IgM, and HDV RNA in 1 830 cases with chronic HBV infection were 2.24% (41/1 830), 1.09% (20/1 830), and 1.69% (31/1 830), respectively. All HDV RNA-positive patients had HDV genotype 1. Two anti-HDV-positive patients had negative hepatitis B surface antigen (HBsAg). Gender, age, HBV course, and anti-HBV treatment status had no significant difference. The quantification of HBsAg, liver biochemical indexes (alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, and total bile acids), the proportion of patients with liver cirrhosis, and alpha-fetoprotein were significantly higher in the anti-HDV-positive group than in those in the anti-HDV-negative group ( P<0.05). Conclusion:The prevalence rate of HDV in chronic HBV-infected patients at a single center in the Xinjiang region was 2.24%, with the primary genotype being 1. Furthermore, overlap infection should be paid attention to because it might aggravate liver damage.

Objective:To evaluate the impact of the surgical strategy of selective thoracic duct(TD) ligation established through fluorescence thoracoscopy TD imaging technology on the occurrence of chylothorax after lung cancer surgery in the elderly.Methods:A prospective cohort study was conducted.Elderly patients who underwent right lung cancer surgery in the Department of Thoracic Surgery of Beijing Hospital from October 2023 to June 2024 were enrolled as the research subjects.The surgical approaches involved pulmonary resection, systematic lymphadenectomy, and selective TD ligation using fluorescence thoracoscopy.Prior to the surgery, 0.4 mg/kg indocyanine green(ICG)was injected subcutaneously into the right inguinal region of all patients.Clinical data, surgical details, pathological information, and intraoperative TD imaging, including the course, collateral vessels, and any injuries, were collected.Postoperative chylothorax and other complications were also recorded.Results:A total of 83 patients were enrolled, of which 38 were males, and 45 were females, with a median age of 68 years raging from 60 to 83 years old, TD imaging was observed in 69 cases(83.1%)within one hour after IGC injection.Intraoperative injuries of collateral branches were visualized in 4 cases(4.8%). Among them, 2 cases had injuries in both the 2R+ 4R and the subcarinal station, while 2 others had injuries of collateral branches only in the 2R+ 4R station.These 4 patients underwent concurrent TD ligation.No TD or collateral injury was found in the remaining patients during the surgery, and the TD was not ligated, none of the patients developed chylothorax postoperatively, and no adverse reactions related to indocyanine green were observed.Conclusions:Fluorescence thoracoscopy-guided TD imaging technique can well visualize TD and its collateral injuries in elderly lung cancer surgeries, assist in the management of leaks or TD ligation, thereby effectively preventing the occurrence of postoperative chylothorax.

ObjectiveTo examine the relationship between metabolic syndrome (MS) and its key components in granulomatous mastitis (GM), we explored potential pathological mechanisms through the lens of traditional Chinese medicine (TCM), particularly the concept of intermingled phlegm-blood stasis.MethodsIn this retrospective study, we enrolled 172 patients with GM and 164 patients with non-inflammatory benign breast masses. Metabolic indicators (waist circumference [WC], blood lipids, etc.), inflammatory markers (C-reactive protein, interleukin-6, tumor necrosis factor-α), and adipose tissue CD68 expression were measured. Logistic regression was used to analyze risk factors and receiver operating characteristic curves were used to evaluate diagnostic efficacy. The correlation between TCM pathogenesis and biomarkers was also examined.ResultsMS prevalence was significantly higher in the GM group than in the controls (26.16% vs. 6.10%, P .001). Multivariate analysis identified abdominal obesity (WC ≥ 80 cm, odds ratio [OR] = 1.065) and low levels of high-density lipoprotein cholesterol (HDL-C; 1.29 mmol/L, OR = 0.066) as independent risk factors for GM (P .001 for both). Among patients with GM, HDL-C levels were inversely correlated with inflammatory markers (r = −0.341 to −0.440), whereas patients with concurrent MS demonstrated greater CD68 macrophage infiltration (P .001). According to TCM, abdominal obesity corresponds to “spleen deficiency with phlegm-dampness accumulation,” and low HDL-C reflects “deficiency of vital qi,” which collectively lead to phlegm-blood stasis obstruction in the mammary collaterals; this aligns with the key MS driving mechanisms of chronic inflammation and immune dysregulation.ConclusionMS promotes GM development through chronic inflammation and immune dysregulation, with abdominal obesity and low HDL-C levels serving as core risk factors. The TCM theory of intermingled phlegm-blood stasis provides a novel interpretation of the metabolic-inflammatory mechanisms underlying GM. Accordingly, we propose phlegm-resolving and blood-activating strategies as potential therapeutic approaches for metabolic–immune axis regulation.

Objective To explore the correlation between single-leg standing posture control and ankle plantar flexor muscle stability,so as to provide a new theoretical basis for improving the ability of human posture control.Methods A total of 20 healthy male college students were randomly selected as the experimental subjects.The iBalance tester and training system was used to test the trajectory data of the center of pressure(COP)of the foot standing on one leg.The CON-TREX MJ multi-joint isokinetic test and training system was used to test the moment amplitude data during the contraction of ankle plantar flexor muscles.Univariate repeated measures variance analysis was used to analyze the standard deviation data of ankle plantar flexor moment amplitude between groups.The Pearson correlation coefficient was used to study the correlation.Results The greater the intensity of the muscle stabilization task performed by the ankle plantar flexor muscle,the greater the standard deviation of the moment amplitude.The C90 area was positively correlated with the coefficient of variation(CV)of the 10％maximum voluntary contraction(MVC)moment of ankleplantar flexor muscle(r=0.761,P＜0.05)during single-leg standing without interference.The C90 area was positively correlated with the CV(r=0.632,P＜0.05)of the 30％MVC moment of ankle plantar flexor muscle during single-leg standing.When the proprioception was interfered during single-leg standing,the C90 area was positively correlated with the CV(r=0.583,P＜0.05)of the 20％MVC moment amplitude of ankleplantar flexor muscle.Conclusions With the increasing difficulty of muscle strength stabilization performed by the ankle plantar flexor muscles,muscle stability decreases.There is a positive correlation between ankle plantar flexor strength stability and single-leg standing posture control.Compared with the case without interference,under visual and proprioceptive interference,an additional information input is reduced or disturbed,and it is more difficult to maintain body balance,and the ankle plantar flexor muscle needs a higher muscle stability in the force mode to participate in the posture control of the human body during single-leg standing.

Objective To classify the foot types of young Chinese males,extract characteristic indicators of foot types,and construct a standard foot type database.Methods Foot type data from 1 483 healthy young male individuals were collected.Spectral clustering algorithm was utilized to categorize foot types,and a deep neural network(DNN)was employed for training the classification model.Layer-wise relevance propagation(LRP)and the correlation coefficient method were combined to extract foot type features,and the differences in various foot type characteristics were compared.Results Spectral clustering yielded 4 distinct foot type categories.Foot type 1 was characterized by a high-arched foot with a prominent big toe,inwardly rotated 5th toe,and a high heel with a wide foot;foot type 2 was characterized by a narrow foot with hallux valgus;foot type 3 was characterized by a low-arched foot with hallux valgus;foot type 4 was characterized by a high-arched foot with a prominent big toe.By integrating interpretable neural networks and the correlation coefficient method,nine indicators were extracted from 27 foot type indicators,including the heel to the sole length,hallux height,navicular bone height,lateral malleolus height,hallux valgus angle,5th toe angle,dorsal foot circumference,heel angle,and longitudinal arch angle.The classification model constructed with these extracted indicators achieved an overall discrimination accuracy rate of 93.67％.Conclusions Chinese young males can be classified into four typical foot types.By examining the rearfoot,midfoot,and forefoot regions,nine key foot morphology parameters,including length,height,circumference,and angle,can be extracted.These parameters provide both theoretical and empirical support for establishing normative data on foot morphology for Chinese young males and for advancing biomechanical researches on the foot and ankle.

Objective To explore the effect of cognitive-motor dual tasks with different cognitive loads(none,simple and difficult)on activation of prefrontal cortex and static posture control in young man.Methods From June to July,2024,27 healthy male college students were recruited in Hebei Normal University.Static postural control parameters(C90 area),lower limb electromyography data(muscle energy proportion)and pre-frontal cortex hemodynamic signals of subjects under single task without cognitive load,dual-task with simple cognitive load,and dual-task with difficult cognitive load were collected using a balanced testing and training system,a wireless surface electromyography device,and functional near-infrared spectroscopy technology.Results The C90 areas of dual-tasks with simple and difficult cognitive load were smaller than that of the single task without cognitive load(P<0.05).The proportion of β band energy in the medial and lateral gastrocnemius mus-cles in the dual-task with simple cognitive load was greater than that in the single task without cognitive load(P<0.05),while the proportion of piper band energy in the lateral gastrocnemius muscle and tibialis anterior muscle was less(P<0.05).During dual-task with difficult cognitive load,the activation levels of bilateral ventro-lateral prefrontal cortex and right dorsolateral prefrontal cortex were higher than those in the single task without cognitive load(P<0.05).Conclusion Dual tasks with appopriate cognitive loads are effective on postural stability in young man.Simple cognitive load promote posture maintenance through optimizing the neuromuscular control of the lower limb muscle groups,while difficult cognitive load through activating the right prefrontal cortex involved in working memory and executive control,involving the neurocognitive compensatory.

Objective To explore the correlation between single-leg standing posture control and ankle plantar flexor muscle stability,so as to provide a new theoretical basis for improving the ability of human posture control.Methods A total of 20 healthy male college students were randomly selected as the experimental subjects.The iBalance tester and training system was used to test the trajectory data of the center of pressure(COP)of the foot standing on one leg.The CON-TREX MJ multi-joint isokinetic test and training system was used to test the moment amplitude data during the contraction of ankle plantar flexor muscles.Univariate repeated measures variance analysis was used to analyze the standard deviation data of ankle plantar flexor moment amplitude between groups.The Pearson correlation coefficient was used to study the correlation.Results The greater the intensity of the muscle stabilization task performed by the ankle plantar flexor muscle,the greater the standard deviation of the moment amplitude.The C90 area was positively correlated with the coefficient of variation(CV)of the 10％maximum voluntary contraction(MVC)moment of ankleplantar flexor muscle(r=0.761,P＜0.05)during single-leg standing without interference.The C90 area was positively correlated with the CV(r=0.632,P＜0.05)of the 30％MVC moment of ankle plantar flexor muscle during single-leg standing.When the proprioception was interfered during single-leg standing,the C90 area was positively correlated with the CV(r=0.583,P＜0.05)of the 20％MVC moment amplitude of ankleplantar flexor muscle.Conclusions With the increasing difficulty of muscle strength stabilization performed by the ankle plantar flexor muscles,muscle stability decreases.There is a positive correlation between ankle plantar flexor strength stability and single-leg standing posture control.Compared with the case without interference,under visual and proprioceptive interference,an additional information input is reduced or disturbed,and it is more difficult to maintain body balance,and the ankle plantar flexor muscle needs a higher muscle stability in the force mode to participate in the posture control of the human body during single-leg standing.

Objective To explore the effect of cognitive-motor dual tasks with different cognitive loads(none,simple and difficult)on activation of prefrontal cortex and static posture control in young man.Methods From June to July,2024,27 healthy male college students were recruited in Hebei Normal University.Static postural control parameters(C90 area),lower limb electromyography data(muscle energy proportion)and pre-frontal cortex hemodynamic signals of subjects under single task without cognitive load,dual-task with simple cognitive load,and dual-task with difficult cognitive load were collected using a balanced testing and training system,a wireless surface electromyography device,and functional near-infrared spectroscopy technology.Results The C90 areas of dual-tasks with simple and difficult cognitive load were smaller than that of the single task without cognitive load(P<0.05).The proportion of β band energy in the medial and lateral gastrocnemius mus-cles in the dual-task with simple cognitive load was greater than that in the single task without cognitive load(P<0.05),while the proportion of piper band energy in the lateral gastrocnemius muscle and tibialis anterior muscle was less(P<0.05).During dual-task with difficult cognitive load,the activation levels of bilateral ventro-lateral prefrontal cortex and right dorsolateral prefrontal cortex were higher than those in the single task without cognitive load(P<0.05).Conclusion Dual tasks with appopriate cognitive loads are effective on postural stability in young man.Simple cognitive load promote posture maintenance through optimizing the neuromuscular control of the lower limb muscle groups,while difficult cognitive load through activating the right prefrontal cortex involved in working memory and executive control,involving the neurocognitive compensatory.

Objective To classify the foot types of young Chinese males,extract characteristic indicators of foot types,and construct a standard foot type database.Methods Foot type data from 1 483 healthy young male individuals were collected.Spectral clustering algorithm was utilized to categorize foot types,and a deep neural network(DNN)was employed for training the classification model.Layer-wise relevance propagation(LRP)and the correlation coefficient method were combined to extract foot type features,and the differences in various foot type characteristics were compared.Results Spectral clustering yielded 4 distinct foot type categories.Foot type 1 was characterized by a high-arched foot with a prominent big toe,inwardly rotated 5th toe,and a high heel with a wide foot;foot type 2 was characterized by a narrow foot with hallux valgus;foot type 3 was characterized by a low-arched foot with hallux valgus;foot type 4 was characterized by a high-arched foot with a prominent big toe.By integrating interpretable neural networks and the correlation coefficient method,nine indicators were extracted from 27 foot type indicators,including the heel to the sole length,hallux height,navicular bone height,lateral malleolus height,hallux valgus angle,5th toe angle,dorsal foot circumference,heel angle,and longitudinal arch angle.The classification model constructed with these extracted indicators achieved an overall discrimination accuracy rate of 93.67％.Conclusions Chinese young males can be classified into four typical foot types.By examining the rearfoot,midfoot,and forefoot regions,nine key foot morphology parameters,including length,height,circumference,and angle,can be extracted.These parameters provide both theoretical and empirical support for establishing normative data on foot morphology for Chinese young males and for advancing biomechanical researches on the foot and ankle.